Improving the impact of pharmacy interventions towards better patient care, health outcomes and prescribing practice

Powys Teaching Health Board

Clinical and pharmaceutical interventions (PI) made by pharmacy professionals can have significant impact in ensuring optimised patient care and safety around medicines. Interventions include rationalising prescriptions and reducing / preventing medication errors by ensuring appropriate therapeutic choices. Recording pharmacy interventions yields essential data to inform the clinical, humanistic and economic impact of pharmacy teams, according to the ECHO model. It also allows learning to be shared with other professionals, improves prescribing practice and builds resource and capacity planning, ensuring appropriate skill mix of staff.

Between October 2020 and October 2021, the community hospitals at Powys Teaching Health Board recorded 158 pharmacy interventions, corresponding to a recording rate of 0.4 interventions per pharmacy staff per week. These figures were not a true representation of the work of a pharmacy professional.

Through two 10-week Plan-Do-Study-Act (PDSA) cycles, a project was undertaken to understand the reason for the low number of interventions previously recorded and applied a systems-thinking method on managing change in healthcare.

In the beginning of PDSA cycle 1 of this project, it was highlighted that the record of PI lacked representativity and significance. Besides the low number of interventions recorded, the team was not motivated to, and did not understand the importance of, recording this data. The results showed that an effective recording tool, that reflects the organisation’s wants and needs, is key for increasing the number of PI documented.

The implementation of xPIRT toolkit (xPIRT + xPIRT List + xPIRT Dashboard) and applied theory on managing change in healthcare, was able to increase the number of PI recorded by the hospital pharmacy teams and thus improve their impact. By the end of the project, a total of 254 interventions were recorded, 41.4% above the overall target.

Rafael Baptista

rafael.baptista@wales.nhs.uk